Zambezia Province Research Articles

Sociocultural understanding of Tuberculosis and implications for care-seeking among adults in the province of Zambezia, Mozambique: Qualitative research.

Mozambique has a high burden of Tuberculosis (TB) with an incidence of 368 per 100,000 population in 2020, coupled with a low all-form TB detection rate. The COVID-19 pandemic has exacerbated delays in timely diagnosis and treatment of new TB cases. Promoting active TB case finding is a national priority in Mozambique. We conducted qualitative research to explore factors influencing TB testing in Zambezia province in Mozambique. One-to-one, semi-structured, audio-recorded telephone interviews were conducted to explore TB-related knowledge, and barriers and facilitators to TB testing. A sample of two TB Program staff, two community providers of TB services, and 19 community members (10 women and 9 men) was recruited, with support from provincial government TB staff, from four districts in Zambezia with a high TB burden. Interviews were transcribed verbatim, and thematic analysis was conducted. The Mozambican National Bioethics Committee for Health approved the study protocol. Our study highlights that knowledge about TB symptoms and its causes is low, which could delay timely TB testing. Sociocultural beliefs often implicate certain types of sexual activity and women as causes of TB symptoms; for example, having sex with a widow who has not been traditionally purified, or with a woman who has had an abortion. Therefore, people usually tend to first seek care from traditional healers instead of going to a health facility. Additionally, stigma associated with HIV and TB also delays care seeking. Gender-related disparities in TB care seeking were also evident. This study provides valuable insights into how healthcare seeking for TB is influenced by sociocultural understanding of symptoms and gender dynamics. Therefore, interventions to promote timely and appropriate care seeking for TB should be contextually tailored, culturally appropriate, and gender sensitive.

Uncertainty and Forest Concessions in a Globalized World: Insights into Local Access to Forest Resources in Mozambique

Forest-based communities are embedded in complex and uncertain global processes. We aim to understand the repercussions of uncertainty on forest-based livelihoods through a focus on implications in terms of access to resources for inhabitants of forest concessions. Uncertainty is conceptualized as unpredictability (not knowing), limited knowledge (knowing too little), and ambiguity (knowing too much, too differently). This research is based on document analysis and a case study in Zambezia Province, Mozambique. In-depth interviews and observations were conducted in local communities and triangulated with interviews with NGOs, researchers, and government officials. The findings indicate that multiple actors draw on formal and informal institutions to mediate access to forest-derived resources, which exacerbates uncertainties. Unpredictability, limited knowledge, and ambiguity undermine access to such resources for local communities. This paper contributes to an understanding of uncertainty and suggests a collaborative approach to reduce and cope with different uncertainties in the quest toward sustainable forest-based livelihoods.

Quality of routine data for monitoring nutrition and diarrhoea indicators of children under 5 in Mozambique: an ecological study over a 5-year period

BackgroundUndernutrition and diarrhoea have a high burden in children under 5 in low/middle-income countries. Having data-driven quality health services for these two diseases is key in order to address the...

BOHEMIA a cluster randomized trial to assess the impact of an endectocide-based one health approach to malaria in Mozambique: baseline demographics and key malaria indicators

BackgroundMany geographical areas of sub-Saharan Africa, especially in rural settings, lack complete and up-to-date demographic data, posing a challenge for implementation and evaluation of public health interventions and carrying out large-scale health research. A demographic survey was completed in Mopeia district, located in the Zambezia province in Mozambique, to inform the Broad One Health Endectocide-based Malaria Intervention in Africa (BOHEMIA) cluster randomized clinical trial, which tested ivermectin mass drug administration to humans and/or livestock as a potential novel strategy to decrease malaria transmission.MethodsThe demographic survey was a prospective descriptive study, which collected data of all the households in the district that accepted to participate. Households were mapped through geolocation and identified with a unique identification number. Basic demographic data of the household members was collected and each person received a permanent identification number for the study.Results25,550 households were mapped and underwent the demographic survey, and 131,818 individuals were registered in the district. The average household size was 5 members and 76.9% of households identified a male household head. Housing conditions are often substandard with low access to improved water systems and electricity. The reported coverage of malaria interventions was 71.1% for indoor residual spraying and 54.1% for universal coverage of long-lasting insecticidal nets. The median age of the population was 15 years old. There were 910 deaths in the previous 12 months reported, and 43.9% were of children less than 5 years of age.ConclusionsThe study showed that the district had good coverage of vector control tools against malaria but sub-optimal living conditions and poor access to basic services. The majority of households are led by males and Mopeia Sede/Cuacua is the most populated locality in the district. The population of Mopeia is young (< 15 years) and there is a high childhood mortality. The results of this survey were crucial as they provided the household and population profiles and allowed the design and implementation of the cluster randomized clinical trial.Trial registration NCT04966702.

ADULT EDUCATION, CULTURAL IDENTITY AND LOCAL DEVELOPMENT IN MOZAMBIQUE

The article is the result of a research study carried out in Zambezia, Mozambique, with 250 students attending adult education. Its objective is to analyze the current situation of the illiteracy-extreme poverty relation within Mozambican society looking for remote and immediate causes. The research aims to ultimately make, a strategic contribution in adult education in terms of practical and operative indication in view of development. Mixed methods research design was used combining qualitative (25 adult students interviewed, five in five schools) and quantitative approaches (250 students submitted to the questionnaire, fifty in each school) in a representative and proportional casual sample from five districts of Zambezia Province. The sample requirement was that students had to be undergoing adult education. The research hypothesis was “The more adult education includes the elements of cultural identity, the more it contributes to the elimination of illiteracy-extreme poverty and favors local development in rural areas in Mozambique”. From the analysis of textual narratives and statistics the hypothesis was confirmed concluding that adult education, linked to cultural identity, brings local development in rural areas, opposing illiteracy-extreme poverty and dependence on foreign financial packages such as Action Plan for the Reduction of Absolute Poverty (APRAP).

A New Species of Horseshoe Bat (Chiroptera: Rhinolophidae) from Mount Namuli, Mozambique

The ecology of the high-altitude mountains of northern Mozambique is understudied in comparison to surrounding countries. A series of biological surveys have focused on filling this data gap, with Mount Namuli in Zambezia Province one of the focal sites of these expeditions. A biological survey of Mount Namuli in 2009 resulted in the collection of five specimens of a horseshoe bat species (Rhinolophidae) that is here described as a new species from Mozambique. Morphologically, the new species is very similar to Rhinolophus maendeleo Kock, Csorba and Howell, 2000 of the adami-group, but lacks some key morphological characters of this group (large ears, narrow skull, long palate). Molecular reconstructions clearly suggest the new species belongs to the capensis-group, but no members of the adami-group were included in this analysis (due to lacking data). It is thus unclear whether this unexpected phylogenetic position reflects morphological convergences between members of the adami- and capensis-groups, or whether the morphology-based adami-group should be reconsidered. The new species and R. maendeleo share similar external and craniodental measurements, but can be distinguished based on a number of key characters. These include the presence of a bony bar forming the interorbital foramena, rostrum shape, ear length and highly differing bacular morphologies. It also differs from the genetically closely related R. denti Thomas, 1904, R. swinnyi Gough, 1908 (including two recently described cryptic species) and R. simulator Andersen, 1904 by non-overlapping external and cranial measurements. The new species echolocates at a mean peak frequency of 76.9 kHz and shows an affinity to forest habitats, which are highly threatened in the surrounding region. It joins other coastal and montane forest endemics in defining the bat fauna of south-eastern Africa.

Malaria prevention knowledge, attitudes, and practices in Zambezia Province, Mozambique

BackgroundIn Mozambique, socio-economic and cultural factors influence the wide adoption of disease preventive measures that are relevant for malaria control strategies to promote early recognition of disease, prompt seeking of medical care, sleeping under insecticide-treated nets (ITNs), and taking intermittent preventive treatment for pregnant women. However, there is a critical information gap regarding previous and ongoing malaria social and behavioural change (SBC) interventions. The aim of this study is to assess the knowledge, attitudes, practices of beneficiaries of SBC interventions.MethodsA descriptive cross-sectional survey was undertaken in 2018 in two rural districts of Zambezia Province, Mozambique. A structured questionnaire was administered to 773 randomly selected households. Respondents were the adult heads of the households. Descriptive statistics were done.ResultsThe main results show that 96.4% of respondents recalled hearing about malaria in the previous 6 months, 90.0% had knowledge of malaria prevention, and 70.0% of preventive measures. Of the 97.7% respondents that had received ITNs through a mass ITN distribution campaign, 81.7% had slept under an ITN the night before the survey. In terms of source of health information, 70.5% mentioned the role of community volunteers in dissemination of malaria prevention messages, 76.1% of respondents considered worship places (churches and mosques) to be the main places where they heard key malaria prevention messages, and 79.1% asserted that community dialogue sessions helped them better understand how to prevent malaria.ConclusionsResults show that volunteers/activists/teachers played an important role in dissemination of key malaria prevention messages, which brought the following successes: community actors are recognized and people have knowledge of malaria transmission, signs and symptoms, preventive measures, and where to get treatment. There is, however, room for improvement on SBC messaging regarding some malaria symptoms (anaemia and convulsions) and operational research is needed to ascertain the drivers of malaria prevalence and inform the SBC approach.

Intuit of training and the failure of associations of rural producers in the district of Nicoadala / Intuição da formação e o fracasso das associações de produtores rurais no distrito de Nicoadala

The article demonstrates the purpose of training and the failure of most associations of rural producers in the district of Nicoadala, Zambezia province in Mozambique, in the center of the country. In order to compare the origin and the purpose of some associations operating in the district mentioned above, in relation to associations of rural producers with a focus on developed countries, this article excludes in this article, the difference of training, the way of driving the activities of the associations and their productive success. The characteristic dimensioning is also done; and the conditions that mark the differences in the success and failure of the associations in both countries are analyzed, finally, the conditions that do not favor the productive development of the associations of the district are criticized.

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18: a modelling study

SummaryBackgroundHigh-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa.MethodsIn this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit.FindingsThe estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676·5 (513·6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100 000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81·1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020.InterpretationOur estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas.FundingBill & Melinda Gates Foundation.

Assessment of Surgical Care Provided in National Health Services Hospitals in Mozambique: The Importance of Subnational Metrics in Global Surgery.

Surgery plays a critical role in sustainable healthcare systems. Validated metrics exist to guide implementation of surgical services, but low-income countries (LIC) struggle to report recommended metrics and this poses a critical barrier to addressing unmet need. We present a comprehensive national sample of surgical encounters from a LIC by assessing the National Health Services of Mozambique. A prospective cohort of all surgical encounters from Mozambique's National Health Service was gathered for all provinces between July and December 2015. Primary outcomes were timely access, provider densities for surgery, anesthesiology, and obstetrics (SAO) per 100,000 population, annualized surgical procedure volume per 100,000, and postoperative mortality (POMR). Secondary outcomes include operating room density and efficiency. Fifty-four hospitals had surgical capacity in 11 provinces with 47,189 surgeries. 44.9% of Mozambique's population lives in Districts without access to surgical services. National SAO density was 1.2/100,000, ranging from 0.4/100,000 in Manica Province to 9.8/100,000 in Maputo City. Annualized national surgical case volume was 367 procedures/100,000 population, ranging from 180/100,000 in Zambezia Province to 1,897/100,000 in Maputo City. National POMR was 0.74% and ranged from 0.23% in Maputo Province to 1.78% in Niassa Province. Surgical delivery in Mozambique falls short of international targets. Subnational deficiencies and variations between provinces pose targets for quality improvement in advancing national surgical plans. This serves as a template for LICs to follow in gathering surgical metrics for the WHO and the World Bank and offers short- and long-term targets for surgery as a component of health systems strengthening.

Reduced exposure to malaria vectors following indoor residual spraying of pirimiphos-methyl in a high-burden district of rural Mozambique with high ownership of long-lasting insecticidal nets: entomological surveillance results from a cluster-randomized trial

BackgroundThe need to develop new products and novel approaches for malaria vector control is recognized as a global health priority. One approach to meeting this need has been the development of new products for indoor residual spraying (IRS) with novel active ingredients for public health. While initial results showing the impact of several of these next-generation IRS products have been encouraging, questions remain about how to best deploy them for maximum impact. To help address these questions, a 2-year cluster-randomized controlled trial to measure the impact of IRS with a microencapsulated formulation of pirimiphos-methyl (PM) in an area with high ownership of long-lasting insecticidal nets (LLINs) was conducted in a high-transmission district of central Mozambique with pyrethroid resistant vectors. Presented here are the results of the vector surveillance component of the trial.MethodsThe 2 year, two-armed trial was conducted in Mopeia District, Zambezia Province, Mozambique. In ten sentinel villages, five that received IRS with PM in October–November 2016 and again in October–November 2017 and five that received no IRS, indoor light trap collections and paired indoor-outdoor human landing collections catches (HLCs) were conducted monthly from September 2016 through October 2018. A universal coverage campaign in June 2017, just prior to the second spray round, distributed 131,540 standard alpha-cypermethrin LLINs across all study villages and increased overall net usage rates in children under 5 years old to over 90%.ResultsThe primary malaria vector during the trial was Anopheles funestus sensu lato (s.l.), and standard World Health Organization (WHO) tube tests with this population indicated variable but increasing resistance to pyrethroids (including alpha-cypermethrin, from > 85% mortality in 2017 to 7% mortality in 2018) and uniform susceptibility to PM (100% mortality in both years). Over the entire duration of the study, IRS reduced An. funestus s.l. densities by 48% (CI95 33–59%; p < 0.001) in indoor light traps and by 74% (CI95 38–90%; p = 0.010) during indoor and outdoor HLC, though in each study year reductions in vector density were consistently greatest in those months immediately following the IRS campaigns and waned over time. Overall there was no strong preference for An. funestus to feed indoors or outdoors, and these biting behaviours did not differ significantly across study arms: observed indoor-outdoor biting ratios were 1.10 (CI95 1.00–1.21) in no-IRS villages and 0.88 (CI95 0.67–1.15) in IRS villages. The impact of IRS was consistent in reducing HLC exposures both indoors (75% reduction: CI95 47–88%; p = 0. < 0.001) and outdoors (68% reduction: CI95 22–87%; p = 0.012). While substantially fewer Anopheles gambiae s.l. were collected during the study, trends show a similar impact of IRS on this key vector group as well, with a 33% (CI95 7–53%; p = 0.019) reduction in mosquitoes collected in light traps and a non-statistically significant 39% reduction (p = 0.249) in HLC landing rates.ConclusionIRS with PM used in addition to pyrethroid-only LLINs substantially reduced human exposures to malaria vectors during both years of the cluster-randomized controlled trial in Mopeia—a high-burden district where the primary vector, An. funestus s.l., was equally likely to feed indoors or outdoors and demonstrated increasing resistance to pyrethroids. Findings suggest that IRS with PM can provide effective vector control, including in some settings where pyrethroid-only ITNs are widely used.Trial registrationclinicaltrials.gov, NCT02910934. Registered 22 September 2016, https://www.clinicaltrials.gov/ct2/show/NCT02910934.

Are we interconnected? A qualitative study on the role and perception of different actors on malaria social behaviour change interventions in rural Mozambique

BackgroundInterconnecting institutions (health and education sector) and community (through a network of community structures) in social and behaviour change (SBC) activities can add value in an effort for malaria prevention towards a long-term objective of elimination. This approach has been implemented since 2011 in some rural districts of Mozambique. The objective of this study is to describe the perceptions of community and institutional actors on malaria prevention interventions in rural Mozambique.MethodsA descriptive qualitative study with a constructivist research paradigm was conducted in October 2018 in two rural districts of Zambezia Province with high malaria burden in Mozambique. Key-informant sampling was used to select the study participants from different actors and layers: malaria community volunteers, health professionals, non-governmental actors, and education professionals. In-depth interviews (IDIs) and focus group discussions (FGDs) were used to explore the perceptions of these actors. Classic content analysis looking for themes and semantics was used, and saturation guided the sample size recruitment.ResultsA total of 23 institutional actor IDIs took place, and 8 FGDs were held. Four themes emerged from the content analysis: (1) organizational and functional aspects; (2) knowledge about malaria; (3) perception of institutional actors on SBC and community involvement; and, (4) perception of institutional actors on the coordination and leadership on SBC malaria interventions. Community structures were well organized, linked to the health sector and operational, with good knowledge of malaria prevention. Education sector (school teachers) links with the health sector were in some cases good, and in other cases, non-existent. The importance of SBC interventions for malaria control was recognized by health actors, although the activities are delegated to non-governmental institutions. Domestic budgetary allocation constraints, quality of intervention and lack of SBC standard indicators were also identified by health actors as aspects for improvement.ConclusionsCommunity structures, volunteers and primary school teachers have good knowledge on malaria prevention and regularly sensitize community members and students. Institutional health actors and partners recognize their role on malaria prevention activities, however, more interconnection is needed at different levels.

Phylogenetics of the freshwater crab (Potamonautes MacLeay, 1838) fauna from ‘sky islands’ in Mozambique with the description of a new species (Brachyura: Potamoidea: Potamonautidae)

Patterns and processes of cladogenesis among taxa living on the Mozambique ‘sky islands’ remain poorly studied. During the present study, we report on a new freshwater crab species from Mount Lico, an inselberg and ‘sky island’ in the Zambezia Province of Mozambique. Phylogenetic analyses using three mitochondrial DNA sequence loci (12S rRNA, 16S rRNA and COI) were used to determine the evolutionary placement of the freshwater crab specimens from Mount Lico. The freshwater crab specimens from Mount Lico were retrieved sister to Potamonautes choloensis. The new species, Potamonautes licoensis sp. nov., is described and compared with other southern African freshwater crab species. Divergence time estimations for the Mozambican freshwater crab species suggest a Miocene / Plio–Pleistocene diversification. Some endemic ‘sky island’ species form an early branching and are sister to other predominantly East African species, while other ‘sky island’ species are more recently derived and nested within a predominantly southern African clade. The present study presents the description of the fourth endemic freshwater crab species from Mozambique and suggests that the species diversity in the country is likely highly underrepresented, reiterating the call for renewed systematic surveys. An argument for the conservation of these mountainous ‘sky islands’ is presented.

Holistic geospatial data-based procedure for electric network design and least-cost energy strategy

The identification of the best electrification strategy is a fundamental step to increase energy access in rural areas of developing countries. The objective of the present work is to propose a new geospatial-based procedure for rural electrification planning, able to select and design an effective energy system for a defined geographical region. The least-cost solution among stand-alone mini-grids and connection to the existing national grid of non electrified communities is identified. Spatial information is exploited to compute renewable resources potential, to identify populated areas, subdivide them into clusters, and to design the electrical network connecting the clusters' consumers pursuing the minimization of costs. To this end, an iterative minimum-path algorithm has been developed by the authors. It is able to approximate the Minimum Steiner Tree also for graphs with many terminal points, accounting for a weighted cost surface, which represents the real cost of installing electric feeders in difficult areas. The performance of the procedure has been tested in the rural area of Namanjavira, in the Zambezia Province, Mozambique, where 6 microgrids and 2 interconnected grids were designed. The inclusion of distribution grid costs and penalties related to real terrain morphology lead to a significant increase (up to 200%) of the total cost, highlighting the cornerstone role of a spatial approach in the identification of the best electrification strategy.

Mapping smallholder and large-scale cropland dynamics with a flexible classification system and pixel-based composites in an emerging frontier of Mozambique

Remote sensing assessments of land use and land cover change (LULCC) are critical to improve understanding of socio-economic, institutional and ecological processes that lead to and stem from land use change. This is particularly crucial in the emerging frontiers of Southern Africa, where there is a paucity of LULCC studies relative to the humid tropics. This study focuses on Gurué District (5606 km2) of Zambezia province of Mozambique, one of many countries in the region that has experienced a recent growth in foreign investments in agriculture through large-scale land acquisitions, often resulting in land use conversions and modifications. Previous LULCC assessments covering Mozambique have focused on dynamics between natural and anthropogenic land categories, with limited efforts to distinguish the different land use agents associated with these changes, and relating this with social, economic and technological processes. In this study we built a new LULC assessment methodology that leverages the power of open remote sensing data and tools to integrate categorical and continuous training and validation data obtained from field surveys and Collect Earth software within Google Earth Engine. We then examined the suitability of five pixel-based compositing techniques for generating cloud-free Landsat images that can support analysis of land use dynamics in persistently cloudy, mosaic landscapes with more limited Landsat archives. Drawing upon the spectral and textural features of Landsat data in pixel-based composites, we classified land use over three time periods, 2006, 2012 and 2016, and characterized land use change, focusing on changes between small-scale cropland, large-scale mechanized cropland, and other land uses. This method can be upscaled and applied in many parts of Africa with similar historic image availability challenges, and similar economic contexts with great disparities between small-scale unmechanized cropland and very large-scale mechanized cropland, to explore land consolidation dynamics and agent-specific pathways of land use change.

A synopsis of Polysphaeria (Rubiaceae) in Mozambique, including two new species

The genus Polysphaeria is investigated in Mozambique based on detailed morphological studies of herbarium specimens, resulting in the recognition of two new species. The first, P. ribauensis, is based on Kraussia sp. A of Flora Zambesiaca and is endemic to the Ribaue Mountains of Nampula Province. The second, P. harrisii, is known only from Mount Mabu and Mount Ile in Zambezia Province, and has previously been confused with P. lanceolata. The affinities of these two species are discussed and a synopsis of the genus in Mozambique is presented, including a key to the five species now recognised, and notes on the distribution, ecology and conservation status of each species.

PO 8276 COMMUNITY INDEX CASE APPROACH AND HIV TESTING AND COUNSELING (HTC) FOR SEXUAL PARTNERS OF HIV-POSITIVE PATIENTS LOST TO FOLLOW-UP: THE EXPERIENCE OF WORLD VISION MOZAMBIQUE

BackgroundHIV-positive patients lost to follow-up (HP-LTFU) represent a challenge for HIV/AIDS control efforts as they are associated with higher risk of HIV transmission to their sexual partners, low viral load suppression and higher risk of morbidity and mortality than adherent patients. The SCIP-Ogumaniha programme implemented by World Vision Mozambique, has been utilising the index case approach together with systematic home-based HIV testing and counseling (hHTC) since August 2016 in 7 districts of the Zambezia province. This abstract outlines an evaluation of the contribution of this approach to HIV/AIDS care and treatment (HACT) of sexual partners of HP-LTFU in alignment with the first and second targets of the 90–90–90 UNAIDS strategy.MethodsThe study involved HP-LTFU returned to HACT between October 2016 and September 2017. These patients reported to have sexual partners who had not been tested for HIV and provided informed, written consent for joint hHTC with these individuals. The hHTC package for sexual partners was offered by World Vision project counselors and those who tested HIV-positive were referred to HACT.ResultsOf 7.084 patients who returned to HACT and reported to have an untested sexual partner, 63% (4,471) provided informed, written consent for joint hHTC. Of 4264 sexual partners found and tested, 52% was female, 64% was in the 15–34 age groups, and 88% had never been tested for HIV. About 28% (1.205/4.264) was HIV-positive, 56% of the sexual partners who tested HIV-positive, was female and 98% of these was successfully referred to HACT.ConclusionThe index case approach together with hHTC has contributed to the early diagnosis of 28% of new HIV infections among sexual partners of HP-LTFU and 98% of them ensured timely linkage to the HACT. Therefore, broader promotion and adoption of this approach would make a significant contribution to achievement of the first and second targets of the 90–90–90 UNAIDS strategy.

Exploring Factors Which Affect Quality of the English Language Teacher Training Programme for Primary Schools in Zambézia

Several factors may affect the quality of the English language teaching and learning process and teacher training as well. This paper seeks to discuss eight factors which influence positive or negatively in the English language teacher training programme for primary schools in Zambezia province. Heyworth is the great scholar, who discusses issues around quality management in English language teaching as a foreign language. His views have inspired the researcher to think over issues, which can foster or undermine the quality of the English language teacher training programme for primary schools in Zambezia province. The researcher stresses that quality of the English language teacher depends mostly of the quality of the management process, through its positive elements and excellent performance of the teacher trainers, the existing teaching and learning materials, motivation by teacher trainees and teacher trainers, and positive attitudes which can be shown by strong professionalism. The qualitative approach was chosen for this study based on discussions and review of authors who have discussed about factors affecting teacher education with focus on English language teacher training. The current study concludes that training English language teachers in a context, where English is taught and learnt as a foreign language demands the disposition of knowledge, skills, competence, motivation, quality of school infrastructure, professionalism and teacher trainers competence which can impact positively in the English language teacher trainee, the future English language teacher.

Coleus namuliensis and Coleus caudatus (Lamiaceae): a new species and a new combination in the Afromontane flora of Mozambique and Zimbabwe

The new species Coleus namuliensis (Lamiaceae) is described from the granite outcrops and grasslands of Mt Namuli in Zambezia Province of Mozambique. It has previously been confused with Plectranthus caudatus, a species that is restricted to the quartzite outcrops of the Chimanimani Mountains on the Mozambique-Zimbabwe border for which the new combination in Coleus is formalised in this paper. Other potential confusion species are discussed and a rationale for applying the generic name Coleus rather than Plectranthus is provided. Despite their highly restricted ranges, C. namuliensis and C. caudatus are both considered to have a conservation status of Least Concern at present, although climate change may pose a longer-term threat to their survival.

Combination of indoor residual spraying with long-lasting insecticide-treated nets for malaria control in Zambezia, Mozambique: a cluster randomised trial and cost-effectiveness study protocol

BackgroundMost of the reduction in malaria prevalence seen in Africa since 2000 has been attributed to vector control interventions. Yet increases in the distribution and intensity of insecticide resistance and...